No abstract available.
Larynx, Artificial* ; Voice*

Humans ; Laryngeal Neoplasms ; surgery ; Larynx ; Larynx, Artificial ; Tracheostomy

Aged ; Humans ; Laryngectomy ; instrumentation ; Larynx, Artificial ; Male ; Middle Aged

OBJECTIVETo explore the methods and results of surgical management for refractory dysphagia and aspiration.

METHODSThe clinical data of 24 refractory dysphagia and aspiration patients who accepted surgical management were retrospectively analysed.

RESULTSTwenty-four refractory dysphagia and aspiration patients accepted 26 operations between 2001 and 2014. Of the 26 operations, 17 were cricopharyngeal myectomy (CPM), 6 were scarectomy, 3 were laryngeal-tracheal separation. No severe complications occurred. Assessments of dysphagia were completed in 18 operations before and after operation. Aspiration scores of videofluoroscopic swallowing study (VFSS) were 4.50 [4.00;7.00] vs 2.00 [1.00; 3.25], P = 0.000; swallow dysfunction scroes of VFSS were 5.00 [4.00; 12.00] vs 1.00 [1.50; 10.00], P = 0.001; aspiration scores of fibroptic endoscopic evaluation of swallowing (FEES) were 4.00 [5.00; 7.00] vs 2.00 [1.75; 3.00], P = 0.000. But the surgical results for post radiotherapy dysphagia were not successful (n = 5): aspiration scores of VFSS were 7.00 [6.50; 8.00] vs 6.00 [2.00; 7.50], P = 0.109;swallow dysfunction scroes of VFSS were 12.00 [10.50; 12.00] vs 12.00 [7.50; 12.00], P = 0.180;aspiration scores of FEES were 7.00 [6.50; 8.00] vs 6.00 [2.00; 7.50], P = 0.109.

CONCLUSIONSurgical management was effective for refractory dysphagia and aspiration, but the surgical indication selection should be strict.

Deglutition Disorders ; surgery ; Endoscopy ; Fluoroscopy ; Humans ; Larynx ; Larynx, Artificial ; Retrospective Studies ; Trachea

OBJECTIVETo investigate the guiding role of narrow-band imaging endoscopy in laryngeal malignant lesion biopsy.

METHODSFrom February 2013 to January 2014, 113 patients suspected of laryngeal malignant lesions after electronic nasopharyngolaryngoscope screening were included in the study. The patients were randomly divided into two groups, 58 cases in group A underwent laryngeal tumor biopsies in the white light mode and 55 cases in group B did in NBI mode. The patients were applied with corresponding surgery treatment according to the biopsy results. Postoperative pathologic examination result was as a gold standard for identifing the laryngeal diseases.

RESULTSThe positive rate of malignant lesions in group A (71.1%, 32/45) was significantly lower than that in group B (95.4%, 42/44) (χ² = 7.75, P < 0.05); the accurate rate of biopsy in group A (77.6%, 45/58) was significantly lower than that in group B (96.4%, 53/55, χ² = 7.09, P < 0.05) .

CONCLUSIONNarrow-band imaging endoscopy can obviously improve in the detection of laryngeal malignant lesion by biopsy.

Biopsy ; methods ; Endoscopy ; methods ; Humans ; Laryngeal Neoplasms ; diagnosis ; surgery ; Laryngoscopy ; Larynx, Artificial

Percutaneous dilatational tracheostomy (PDT) is a widely used method to perform tracheostomy in the critical care medicine for patients who need prolonged mechanical ventilation. Traditionally, PDT has been facilitated by bronchoscopy via the endotracheal tube. However, there are risks for blocking the view of correct puncture site on the trachea or being extubated unintentionally, which lead to loss of the airway. These complications are possibly due to insufficient bronchoscopic visualizations via endotracheal tube during the procedure. Using laryngeal mask airways (LMA) during PDT may overcome these problems and could provide a safer alternative method with superior visualizations of the trachea and larynx. We report a case of percutaneous tracheostomy being performed successfully under bronchoscopy with LMA in the intensive care unit.
Bronchoscopy ; Critical Care ; Humans ; Intensive Care Units ; Laryngeal Masks ; Larynx ; Punctures ; Respiration, Artificial ; Trachea ; Tracheostomy ; Triazenes

OBJECTIVETo explore the survivorship and character of decellularized laryngeal scaffold in pectoralis major muscle flap in canine.

METHODSEighteen donor larynx in experimental group were decellularized by perfusing sodium dodecyl sulphate. Three of them were used to detect the character of histology. The other fifteen ones were embedded in right pectoralis major muscle flap of acceptor canine. Donor larynx in control group were not perfused. Other experimental procedure was the same as experimental group. The specimens were harvested at two weeks, one month and two months after operation, respectively. Macroscopic view, histological examination and trypan blue staining were performed in the experimental group and control group.

RESULTSThe size of the specimens decreased remarkably into disappearance in control group, there was statistical significance between the experimental group and the control group (which used least significant difference t test P < 0.05). There was only little neutrophils and lymphocytes infiltrating around the laryngeal scaffold at 2 weeks in the experimental group. One month after operation, loose connective tissue begin to form around the laryngeal scaffold. After two months of transplantation, the connective tissue became thicker and the number of blood vessels increased than before. There was a large number of lymphocytes and neutrophil infiltration around the laryngeal specimens in the control group at 2nd week. The perichondrium in the control group was damaged at one month post operation. The cartilage cells could not be detected two months after surgery. The survival rate of cartilage cell between experimental group (86.8% ± 3.2%) and the control group (88.6% ± 3.1%) did not show statistical significance before implantation (χ(2) = 0.19, P > 0.05). The survival rate of cartilage cell decreased insignificantly in experimental group while the survival rate declined obviously in the control group at two weeks and one month after operation, the difference had statistical significance (χ(2) were respectively 5.52 and 20.55, P were respectively < 0.05 and < 0.01), the survival rate of cartilage cell in experimental group was (65.8% ± 2.6%) at two months after operation, while the cartilage cell all disappeared in control group.

CONCLUSIONSPerfused decellularation technique can construct a low immunogenicity laryngeal cartilage scaffold which can survive in the chest muscle package and establish a good blood supplement. The decellularized laryngeal scaffold could be used as a biological scaffold for whole laryngeal reconstruction.

Animals ; Cell Culture Techniques ; Chondrocytes ; cytology ; Dogs ; Larynx, Artificial ; Tissue Engineering ; methods ; Tissue Scaffolds

Aged ; Case-Control Studies ; Humans ; Laryngectomy ; rehabilitation ; Larynx, Artificial ; Male ; Middle Aged ; Phonation

Humans ; Esophagus ; Manometry ; Botulinum Toxins/therapeutic use* ; Prostheses and Implants ; Treatment Outcome ; Larynx, Artificial

OBJECTIVETry to use free jejunum flaps reconstruction and laryngeal preservation for squamous cell carcinoma (SCC) in the pharyngoesophageal junction.

METHODSThirteen patients who underwent resections of SCC in the pharyngoesophageal junction with free jejunal interposition from August 2007 to December 2012 were reviewed. Of them, 8 had T3 lesions, 4 had T4 lesions, and one had radiation failure with rT2 lesion. Ten patients were treated with postoperative radiotherapy with a average dosage of 56 Gy.

RESULTSThe 3 year over all survival rate was 47.9% and disease-specific survival rate was 34.2%. The surgical complications occurred in 9 patients (9/13), including one death and one flap failure. Five patients (5/13) had permanent tracheal canulation, 10 patients (10/13) resumed oral feeding and all patients achieved reasonable speech.

CONCLUSIONFree jejunum interposition can be used to reconstruct surgical defect of SCC in the pharyngoesophageal junction, thus preserving the larynx and ensuring a better quality of life for the patients.

Anastomosis, Surgical ; Carcinoma, Squamous Cell ; surgery ; Esophagus ; Humans ; Jejunum ; surgery ; Larynx ; Larynx, Artificial ; Neck ; Postoperative Complications ; Quality of Life ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Survival Rate